• Title/Summary/Keyword: Pediatric Care Unit

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A Clinical Review of Ten Years' Pediatric Surgical Experience (지난 10년간 소아외과 질환의 임상적 고찰)

  • Choi, Soo-Jin-Na;Chung, Sang-Young;Kim, Shin-Kon
    • Advances in pediatric surgery
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    • v.4 no.2
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    • pp.110-116
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    • 1998
  • This is a clinical review of 2,191 pediatric surgical patients under the age of 15 years, operated upon at the Division of Pediatric Surgery, Department of Surgery, Chonnam University Hospital from January 1988 to December 1997. The total number of operations in the pediatric age for all specialties were 13,144(13.2 %). The total operations including those performed on adults were 99,555. The most common age group operated upon was under 5 year of age(44.4 %). The number of operations in Division of General Pediatric Surgery were 2,191(16.7 %) out of total 13,144 operations in all pediatric specialties. The patients under 1 year of age in general pediatric surgery was 42.9 %(941/2,191). The most common diseases in neonates were anorectal malformation(20.6 %) and hypertrophic pyloric stenosis(20.3 %). Infants older than neonates most commonly were operated upon for inguinal hernia(32.4 %) and intussusception(19.6 %). The total mortality rate in the neonatal intensive care unit was 31.3 %. Gastroschisis had the highest mortality.

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Analysis of the Nursing Interventions Performed by Hospital Nurses Using NIC (간호중재분류(NIC)에 근거한 간호중재수행분석 I -병원 간호사를 중심으로-)

  • 염영희
    • Journal of Korean Academy of Nursing
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    • v.29 no.2
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    • pp.346-360
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    • 1999
  • The purpose of this research was to identify nursing interventions performed by hospital nurses in Korea. The sample consisted of 311 nurses working in three hospitals. The Nursing Interventions Use Questionnaire developed by the Iowa Intervention Project team was used for data collection. The instrument was translated to Korean using the method of back-translation. Eighteen interventions were performed at least daily. Interventions in the Physiological : Basic domain were most frequently used at least daily. No interventions in the Family and Behavioral domains were used by nurses at least once a day. The most frequently used interventions was Documentation, followed by the interventions Medication : Parenteral, Intravenous(IV) Insertion, Temperature Control, and Shift Report. The intervention performed least often was Reproductive Technology Management. Nurses working in intensive care units on the whole performed interventions most often, while nurses working in obstetric, gynecological, and pediatric units performed them least often. The nurses working in intensive care unit, medical and surgical care units performed the interventions in the Physiological : Basic domain more often than the nurses working in obstetric, gynecological, and pediatric units. The nurses working in obstetric, gynecological, and pediatric units used the interventions in the Family domain more often than the nurses working in the other three units. This study contributes to the documentation of nursrs' work in Korea. Further study will be needed to validate nursing activities of each NIC intervention.

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Evaluating the Validity of the Pediatric Index of Mortality Ⅱ in the Intensive Care Units (소아중환자를 대상으로 한 PIM Ⅱ의 타당도 평가)

  • Kim, Jung-Soon;Boo, Sun-Joo
    • Journal of Korean Academy of Nursing
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    • v.35 no.1
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    • pp.47-55
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    • 2005
  • Purpose: This study was to evaluate the validity of the Pediatric Index of Mortality Ⅱ(PIM Ⅱ). Method: The first values on PIM Ⅱ variables following ICU admission were collected from the patient's charts of 548 admissions retrospectively in three ICUs(medical, surgical, and neurosurgical) at P University Hospital and a cardiac ICU at D University Hospital in Busan from January 1, 2002 to December 31, 2003. Data was analyzed with the SPSSWIN 10.0 program for the descriptive statistics, correlation coefficient, standardized mortality ratio(SMR), validity index(sensitivity, specificity, positive predictive value, negative predictive value), and AUC of ROC curve. Result: The mortality rate was 10.9% (60 cases) and the predicted death rate was 9.5%. The correlation coefficient(r) between observed and expected death rates was .929(p<.01) and SMR was 1.15. Se, Sp, pPv, nPv, and the correct classification rate were .80, .96, .70, .98, and 94.0% respectively. In addition, areas under the curve (AUC) of the receiver operating characteristic(ROC) was 0.954 (95% CI=0.919~0.989). According to demographic characteristics, mortality was underestimated in the medical group and overestimated in the surgical group. In addition, the AUCs of ROC curve were generally high in all subgroups. Conclusion: The PIM Ⅱ showed a good, so it can be utilized for the subject hospital. better.

Untact Visit Service Development Based on an Application Reflecting the Circumstances during COVID-19: Focusing on Utilization in the Pediatric Intensive Care Units (COVID-19 상황을 반영한 어플리케이션 기반의 언택트 면회 서비스 개발: 소아중환자실에서의 활용을 중심으로)

  • Woo, Dahae;Yu, Hanui;Kim, Hyo Jin;Choi, Minyoung;Kim, Dong Hee
    • Journal of Korean Academy of Nursing
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    • v.51 no.5
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    • pp.573-584
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    • 2021
  • Purpose: This study aimed to develop an untact visit service based on an application that can be utilized in the pediatric intensive care unit (PICU) during COVID-19. Methods: This study adopted the double diamond process of service design comprising the discovery, defining, and development stages. Results: We developed an untact visit service based on an application that considered the child's status, schedule, photo, and video messages, and so on. Moreover, we derived a service flow regarding the required roles and the type of flow shown between each stakeholder. Conclusion: Considering the ongoing pandemic, the untact visit service is designed to increase rapport and participation of parents, share the child's information in real-time, and provide one-stop service without increasing healthcare providers' work. It will be a useful visit service that can be applied and evaluated in various hospital settings and the PICU.

Conservative Management of Tracheal Injury After Endotracheal Intubation in a Neonate with Subglottic Stenosis and Esophageal Atresia with Tracheoesophageal Fistula (식도 폐쇄 및 기관식도루와 성대문밑협착을 동반한 신생아에서 기관 삽관후 발생한 기관 손상의 보존적치료 경험 1예)

  • Jung, Eun-Young;Choi, Soon-Ok;Park, Woo-Hyun
    • Advances in pediatric surgery
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    • v.16 no.1
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    • pp.37-42
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    • 2010
  • Tracheal injury is a rare complication of endo-tracheal intubation. However in neonates, the rates of morbidity and mortality are high. Recommendations for treatment are based on the several reports of this injury and are individualized. Conservative management can be effective in some cases. We describe the case of a neonate who presented with subcutaneous emphysema after intubation in a neonatal intensive care unit. This patient suffered full VACTERL syndrome and had 1.7 mm diameter subglottic stenosis. Conservative management resulted in no further increase in subcutaneous emphysema and after 10 days the patient was stable.

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What can we do for dying neonate in NICU? (죽음, 죽어감, 신생아 중환자실에서 어떻게 받아들여야하나)

  • Chun, Chung-Sik
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.851-855
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    • 2009
  • Death is not only a medical problem; it is also an ethical problem. When doctors face a dying neonate, their knowledge of bioethics and the opinions of ethical specialists and religious leaders are helpful for them and the family of the dying baby. In recent years, due to the increase of surviving babies who have suffered from severe illness, those born too small or too early, and those with severe anomalies in neonatal intensive care unit (NICU), we have met with complicated bioethical problems frequently. To lessen the burdens of doctors and the parents of the dying baby, I reviewed medical, ethical and religious articles about bioethics in adult death. My suggestions are listed as follows: 1) regular bioethical education and activation of bioethical committees in NICU, 2) a well-controlled nationwide database, 3) a hospice unit space and programs for dying baby in NICU, and 4) social support for pregnant women and financial support for the NICU.

Regionalization of neonatal intensive care in Korea

  • Chang, Yun-Sil
    • Clinical and Experimental Pediatrics
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    • v.54 no.12
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    • pp.481-488
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    • 2011
  • In the current era of low-birth rate in Korea, it is important to improve our neonatal intensive care and to establish an integrative system including a regional care network adequate for both high-risk pregnancies and high-risk newborn infants. Therefore, official discussion for nation-wide augmentation, proper leveling, networking, and regionalization of neonatal and perinatal care is urgently needed. In this report, I describe the status of neonatal intensive care in Korea, as well as nationwide flow of transfer of high-risk newborn infants and pregnant women, and present a short review of the regionalization of neonatal and perinatal care in the Unites States and Japan. It is necessary not only to increase the number of neonatal intensive care unit (NICU) beds, medical resources and manpower, but also to create a strong network system with appropriate leveling of NICUs and regionalization. A systematic approach toward perinatal care, that includes both high-risk pregnancies and newborns with continuous support from the government, is also needed, which can be spearheaded through the establishment of an integrative advisory board to propel systematic care forward.

Analysis of Etiology and Prognosis of Pulmonary Complications in Children with Hematological or Oncological Disorders in Pediatric Intensive Care Unit (소아 중환자실에 입원한 혈액-종양 환아에서 발생한 폐 합병증의 원인과 예후에 대한 분석)

  • Jung, Jin Young;Hong, Soo-Jong;An, Young Jun;Kim, Ja Hyung;Seo, Jong Jin;Moon, Hyung Nam;Ghim, Thad
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.1000-1006
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    • 2002
  • Purpose : In the course of treatment, patients with hematological or oncological disorders often develop pulmonary complication. The patients who develop a severe pulmonary complication have a poor outlook. The causes of pulmonary complication are either infectious or non-infectious in origin. We have analyzed the etiology and outcome of these patients admitted to the pediatric intensive care unit of Asan Medical Center. Methods : Medical records of 95 patients on Pediatric oncology service who were admitted to pediatric intensive care unit(PICU) of Asan Medical Center from Jan 1997 to May 2000 were retrospectively reviewed. Results : The mean age of the patients was 8.5 years(2 months-18 years). The underlying malignancies of these 95 patients were as following; acute lymphoblastic leukemia(31 cases), lymphoma (11 cases), acute myeloid leukemia(nine cases), brain tumor(eight cases) and other solid tumors(25 cases). Pulmonary complications included pneumonia, acute respiratory failure, pneumothorax and pleural effusion. The most common cause of pulmonary complication was infection(88%) in etiology. The overall mortality rate was 56.8%. Pulmonary complications in these patients carried high rates of mortality regardless of whether they were immune compromised(76%) or not(69%). Even without pulmonary complications, the hematological or oncological patients admitted to PICU had high mortality rates of 43%. Conclusion : Pulmonary complications are frequent finding in the hematological or oncological patients admitted to Intensive Care Unit. The main etiology of these pulmonary complications was infection, which carried a high mortality rate regardless of their immune status at the time when they were admitted to PICU.

Physical Activity and Fatigue among Pediatric Nurses in a Special Care Unit (특수병동 아동 간호사의 신체활동과 피로)

  • Chae, Sun-Mi;Suh, Eun-Young;Jung, Hyun-Myung;Lee, Ji-Hye
    • Perspectives in Nursing Science
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    • v.15 no.1
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    • pp.18-28
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    • 2018
  • Purpose: This study was designed to explore the levels of physical activity and fatigue among nurses and to identify the relationship between these variables. Methods: Participants were 89 nurses working at an intensive care unit and an operating room in a children's hospital. Data were collected using self-reported questionnaires including the International Physical Activity Questionnaire and Brief Fatigue Inventory. Results: Most of the nurses' physical activity was work related, and there was a significant difference according to the working unit. Nurses with higher work stress and lower job satisfaction showed higher levels of fatigue than their counterparts did. Work-related physical activity and the interference of fatigue with relationships were related positively, whereas transport and leisure time physical activity were negatively related to usual fatigue and the interference of fatigue with life enjoyment. Conclusion: The levels of physical activity and fatigue of nurses were higher than those observed among other populations. The appropriate level of physical activity for these nurses needs to be investigated carefully. Also, in the intervention for nurses' fatigue, their level of work-related and leisure-time physical activity should be considered separately, and their work environment and psychological satisfaction level should be included.

Two cases of Chryseobacterium meningosepticum infection in a neonatal intensive care unit (신생아 중환자실에서 발생한 Chryseobacterium meningosepticum 감염 2례)

  • Yoon, Hye Sun
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.698-701
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    • 2007
  • We report on two premature infants who developed nosocomial infection caused by Chryseobacterium meningosepticum in a neonatal intensive care unit (NICU). One premature infant developed sepsis, meningitis, and hydrocephalus, and was treated successfully with ciprofloxacin plus trimethoprim-sulfamethoxazole combination therapy for 4 weeks and with a ventriculoperitoneal shunt. The other premature infant, who was in a chronically debilitated state, had infection that had colonized only in the respiratory tract but had no clinical signs for 66 days. Extensive environmental surveillance demonstrated that the suction bottle apparatus was the source of infection. We prevented the spread of infection by closing the NICU temporarily, isolating the patients early in their infection, and eradicating the source of infection source.